MEDICARE: MISS JAMIE MICHELLE HAWKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist
2	171M00000X	Case Manager/Care Coordinator
3	106H00000X	Marriage & Family Therapist	148440	CA

General Provider Information

NPI Number	:	1427274661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JAMIE MICHELLE HAWKS

Provider Business Mailing Address
First Line	:	13636 VENTURA BLVD STE 126
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-3700
Country	:	US
Telephone Number	:	661-951-0076
Fax Number	:

Provider Business Practice Location Address
First Line	:	44444 20TH ST W
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-2714
Country	:	US
Telephone Number	:	661-951-0070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	10/28/2024

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